Sense of coherence contributes to physical and mental health in general hospital patients in China

Abstract

The sense of coherence (SOC) may explain why some people become ill under stress whereas others remain healthy. SOC is strongly related to perceived health, particularly mental health. Little is known about the physical and mental health statuses associated with SOC among general hospital outpatients in China. This multicentre cross-sectional study analysed 491 outpatients from four large Chinese general hospitals located in Beijing, Shanghai, Chengdu and Kunming. Patients completed questionnaires examining their SOC (SOC-9), somatic symptom severity (PHQ-15), depression (PHQ-9), generalised anxiety disorder (GAD), health anxiety (WI-7), quality of life (QoL; SF-12) and socio-demographic and clinical characteristics. SOC was negatively correlated with daily-life impairment, symptom duration, somatic symptom severity, depression, GAD and health anxiety, but was positively correlated with age as well as physical and mental QoL. Using a multiple linear regression model, the three strongest correlates of SOC were mental QoL, depression and age. These three variables explained 52% of the variance. SOC may be an important contributor to both mental and physical health in Chinese general hospital outpatients, which is consistent with the results obtained for primary care patients in Western countries. Longitudinal studies are needed to investigate how SOC predicts physical and mental health statuses over time and how these statuses respond to treatment for low SOC.

Keywords:

• sense of coherence
• mental and physical health
• depression
• China

Acknowledgements

We are very grateful to the Chinese team who worked on this study: coordinators Xudong Zhao, Jing Wei, Lan Zhang and Jianzhong Yang and research assistants Nan Shen from Dong Fang Hospital; Heng Wu from Tongji-University; Weijun Chen from Shanghai Mental Health Centre; Xiayuan Sun, Jing Jiang and Nana Xiong from Union Hospital; Ling Zhang from West China Hospital; and Ruixiang Li from Red Cross Hospital of Yunnan Province. Furthermore, we sincerely appreciate the members of the German team from the University Medical Centre Freiburg who worked on this study: Eva März for her work on the translation; Elvira Bozkaya for her work with data management; and Emily Engbers, Anika Dold and Ma Lin for their work as data-entry assistants. The authors thank American Journal Experts for proofreading the manuscript.

Additional information

Funding

Funding. Data collection in China was supported by grant GZ 690 from the Centre for Sino-German Research Promotion in Beijing to Kurt Fritzsche and Xudong Zhao.